Individual provider Active NPI

Jesse Stephen Swyer Novak

  • Dermatology Physician
  • New York, NY
National Provider Identifier
1669310678
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
1669310678 Issued in NY
Practice address
1305 York Ave
New York, NY 10021-5663
Phone
(201) 638-7390
NPI assigned
Mar 23, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 1669310678 NY Primary

Addresses

Primary practice location

1305 York Ave
New York, NY 10021-5663

Mailing address

1305 York Ave
New York, NY 10021-5663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1774224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1669310678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100215663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100215663",
            "telephone_number": "201-638-7390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVAK",
        "first_name": "JESSE",
        "middle_name": "STEPHEN SWYER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-03-23",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "1669310678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.